Objectives

1) investigate associations of factors, including those not previously measured in cohort studies, with prevalence of atherosclerosis and incidence of CHD, heart failure, stroke, atrial fibrillation and the study of factors related to progression of subclinical to clinical cardiovascular disease; 2) characterize heart failure stages, as defined by the American College of Cardiology and American Heart Association (ACC/AHA), in the community; 3) identify genetic and environmental factors leading to ventricular dysfunction and vascular stiffness; 4) assess longitudinal changes in pulmonary function and identify determinants of its decline; and 5) community surveillance to monitor long-term trends in hospitalized MI, CHD deaths, and heart failure (inpatient and outpatient).

Background

Clinical exams were conducted every 3 years from 1987-1998, followed by a period from 2000 to 2011 with follow-up for clinical events but no contract-funded exam. In 2011-2013 a 5th clinical exam was conducted with a focus on characterizing heart failure stages in community-dwelling participants and enabling identification of genetic and environmental factors leading to ventricular dysfunction and vascular stiffness. More than 6,500 participants 69-89 years old attended the 5th exam, which included biospecimen collection, measurement of cardiovascular risk factors, an electrocardiogram, and echocardiogram (with standard and novel echocardiographic techniques), pulmonary function, ankle/brachial index, and pulse wave velocity assessment of vascular stiffness. The ARIC community surveillance enumerates and validates MI, CHD death, and HF events through annual surveillance and produces age-specific and age-adjusted event rates among black and white among residents of the four ARIC Study communities. Since it began in 1987, the study has surveyed hospitalized MI and CHD deaths in residents ages 35-74 years, expanded in 2005 to ages 35-84 years. Also in 2005, the scope of events was expanded to include hospitalized heart failure (HF) for persons ages 55 years and older, with subclassification by chronic stable versus acute decompensated HF. The sampling sources include all acute care hospitals located in the study communities. In 2011, the combined study population included over 400,000 adults 35-84 years old.

Participants

A total of 15,792 participants (55% women, 27% black) were recruited into ARIC from four field centers. Participants from three field centers were recruited from general population samples (Minneapolis, MN; Washington County, MD; Forsyth County, NC) while an all African American cohort was recruited from the metropolitan area of Jackson, MS. Participants were 45 - 64 years of age at enrollment.

Disease Classification

Continuous surveillance for the following events in the cohort: myocardial infarction, in-hospital coronary revascularization, coronary heart disease death, transient ischemic attack, ischemic stroke, hemorrhagic stroke, and fatal stroke. Surveillance for congestive heart failure commenced in 2005. Community surveillance for myocardial infarction (incident and recurrent) and coronary heart disease death. Community surveillance for heart faliure was initiated in 2005.

Design

Longitudinal, multi-site, community population study, 45 - 64 years of age at enrollment

Publications

https://www2.cscc.unc.edu/aric/biblio